Facilitators and barriers of implementing sin-tax policies: a scoping review

Sin taxes, or public health taxes, are excise taxes levied on goods that can harm health. These taxes aim to influence consumer behavior, enhance health outcomes, and generate revenue for health systems. While the effectiveness of sin taxes in influencing consumer behavior has been widely studied, there is limited synthesis of the barriers and facilitators to their implementation. This study specifically reviews these barriers and facilitators, providing insights into the successful sin-tax policy implementation. This study specifically reviews the barriers and facilitators to the implementation of sin-tax policies, focusing on the practical challenges to their adoption and enforcement. This scoping review was conducted in 2024. All documents related to Unhealthy product tax policies were identified using relevant keywords by searching four databases (PubMed, Scopus, Web of Science, and Google Scholar) search engines. In the initial search, 1026 documents were extracted. Based on the selection criteria and reviewing full texts, 61 documents were selected for content analysis. Data analysis was performed using MAXQDA-20. The findings highlighted several barriers to the effective implementation of sin-tax policies. These included policy challenges, such as the influence of industrial lobbying and a lack of coordination among regulatory bodies; consumer-related barriers, like resistance to price increases and limited access to healthier alternatives; and industry-related issues, including the economic impact on businesses in regions dependent on unhealthy products. However, the review also identified key facilitators that could support successful implementation, including greater transparency, stronger community engagement, and the availability of affordable healthy alternatives. These factors could play a crucial role in overcoming the barriers to effective sin-tax policies. We should increase transparency, enhance cooperation, and improve access to healthy products to improve public health. Supporting the transition away from unhealthy options, raising awareness, involving communities, aiding low-income households, and promoting healthy alternatives are also crucial. Targeted subsidies and community engagement are vital to support low-income households impacted by taxes on unhealthy products. Raising public awareness can help shift cultural norms. A comprehensive approach that considers economic, social, and cultural factors is essential for establishing effective "sin taxes" that improve health outcomes and quality of life.